Many Social Security disability claims are denied by the Social Security Administration due to missing or incorrect information and lack of proper evidence. If your claim results in a disability claim denial, you have 60 days from your denial notification date to hire a SSDI attorney and file an appeal with the Social Security Administration.
The SSDI Claim Denial Process in Illinois
In Illinois, all Social Security disability claims are handled by the Bureau of Disability Determination Services (DDS), the state department that makes the initial determinations about the eligibility and denial of disability benefits. When you submit an application to DDS, they review your claim to ensure it contains your correct personal information, the nature of your disability, your work history, the impact of your disability on your job, and medical evidence that supports your claim.
Eligibility for Social Security disability insurance (SSDI) depends on your taxable work history and a sufficient number of earned work credits. The amount of monthly disability benefits you receive is based on your Social Security earnings record. If your benefits are approved, you will receive disability benefits for two years, then you will automatically get Medicare coverage. Approved SSDI benefits are payable to disabled or blind workers under the age of 65, their spouse or widower, their children, and adults disabled since childhood.
Reasons a Disability Claim May Be Denied by the Social Security Administration
Unfortunately, about 40% of SSDI claims submitted for SSDI benefits are denied by the SSA. In 2021, Illinois statistics indicated that the initial disability application approval rate was only 37%. Many claims are denied for the following reasons:
- Missing or inaccurate personal information to verify identity
- Lack of required medical evidence or records to support a claim
- Insufficient work history and work credits
- Reporting false information
- Failure to follow up with requested information
- Failure to submit an application within the required time frame
When filing a claim for SSDI benefits, it’s important to understand the SSA guidelines and provide all information that is requested. Omitting important information, making errors in paperwork, and not responding to emails or calls from the SSA about your claim will slow down the approval process or result in a disability claim denial.
Appealing an SSDI Claim Denial in Illinois
If your SSDI claim is denied by the SSA, you have the right to file an appeal. At this stage, it’s best to hire an Illinois disability lawyer who can file an appeal, rather than filing a new claim. Typically, new claims take 3 to 4 months to process, so starting over isn’t in your best interests. If you file an appeal, your lawyer will be your guide to the SSDI appeals process and help to speed up your claim approval. There are four levels of appeal:
A Request for Reconsideration
If the SSA denies your SSDI claim, you will receive a disability claim denial notice. You then have 60 days from the date on the notice to file a written Request for Reconsideration. A reconsideration is a complete review of your claim by someone who did not take part in the first determination. During the reconsideration stage, the SSA will ask you to submit to further medical examinations, usually by licensed medical professionals who work with the SSA. Your disability lawyer can ensure that the SSA receives all required information regarding your doctor’s visits, medical treatments, medications, and doctors’ and hospital records. If information is missing, your lawyer can communicate with the SSA to ensure that all required information is received.
A Request for an Administrative Legal Hearing
If your claim is denied after reconsideration, you will receive a second notice of denial. You then have 60 days from the date on the notice to make a written request for a hearing before an administration legal judge (ALJ). ALJs are administrative judges that are hired by SSA to conduct hearings. During this hearing, the ALJ may arrange for vocational or medical experts to attend the hearing and testify on pertinent matters.
Chicago Social Security disability lawyers can be an asset to a legal hearing in Illinois because they are familiar with administrative law judges in the district, as well as how each judge likes to conduct a hearing and any biases toward certain medical conditions. This knowledge goes a long way toward winning an appeal during a legal hearing. A large percentage of cases are approved at the ALJ hearing stage of the appeal process.
A Request for Review by the Appeals Council
If an ALJ decision is not favorable, you will receive a third disability claim denial notice. You then have 60 days from the date on the notice to file a Request for Review by the Appeals Council. Your disability lawyer will make a written request for review by the Council. At this point, a review is somewhat limited. Typical reasons for a review by the Appeals Council include errors made by the ALJ; the ALJ decision was not supported by substantial evidence; or an abuse of discretion in the ALJ hearing process.
Your disability lawyer can explain the reasons for requesting a review by the Appeals Council and request additional time to submit a written argument. The Appeals Council can then do one of three things: 1- say that the ALJ was correct in its decision, 2- send the case back to the ALJ with instructions on how to handle the case, or 3- approve the applicant’s claim.
Federal Court Review
If your request for review by the Appeals Council is denied, or you disagree with the Appeals Council’s decision, your disability lawyer can file a civil action in a federal district court. The Federal Court Review is the last level of the Social Security process for appeals.
The Importance of Timely Action
If you plan to file an Illinois Social Security disability claim, pay close attention to filing requirements and take timely action. Procrastinating or missing a filing deadline can result in a disability claim denial letter and the loss of important benefits.
Are There Time Limitations Imposed by the SSA for Filing an Appeal After a Claim Denial?
If your initial SSDI claim is denied, you have four appeal options, but there are time limits imposed for each filing process. When you receive a disability claim denial notice for your initial claim, you must start the appeal process within 60 days of the date on your notice. Each subsequent appeal process has the same 60-day filing timeline from the date on the claim denial notice.
If you hire a Chicago Social Security disability lawyer to represent you through the appeals process, make sure you contact him or her as soon as you are notified that your original disability claim was denied. If you miss the 60-day filing deadline imposed by the SSA, you will have to file a new disability claim, which will add 3 to 7 months to your waiting period for benefits.
Consequences of Waiting to Hire an SSDI Attorney
Navigating the Social Security system is a complex process because of rigid federal and state guidelines and filing requirements. Attempting to do it yourself can easily result in an extensive amount of time and effort, as well as the possibility of a denied SSDI claim due to missing information, inaccurate information, lack of important medical evidence, and missed filing deadlines. You are not required to hire an attorney to file an SSDI claim in Illinois, but it is recommended.
What happens when you fire your attorney for social security disability? Statistically, a much greater number of benefit claims are awarded when individuals have experienced representation. If you delay hiring a SSDI attorney, you miss out on a lot of benefits an attorney can provide:
- Accuracy – Many people who file for Social Security disability benefits do not know how to fill out the SSA questionnaires correctly. Although you can file them online or by mail, you have a better chance of approval if you have an attorney who can address questions and concerns and make sure you don’t make mistakes.
- Knowledge – SSDI attorneys understand the SSA’s guidelines for disability claims and know how to win a disability case. They know what kind of evidence is needed for SSDI approval of initial claims, as well as each type of appeals process.
- Results – Statistically, a much greater number of SSDI claims are awarded when individuals have experienced representation. The SSA recognizes that SSDI attorneys are knowledgeable about state and federal laws and experienced with Social Security claims. Illinois SSDI attorneys commonly work with the Illinois DDS office that handles disability claims.
When filing an SSDI claim, having an attorney in your corner can make all the difference. This is especially true when dealing with a disability claim denial.
